Other organizations have addressed concerns with a receiving facility that has the capacity to evaluate and about SCT and athletic participation (Table 3) discount 8 mg zofran with visa. It is not clear that any of the recommendations SCDAA for medical management are speciﬁc to SCT generic zofran 8mg mastercard. At present cheap 4 mg zofran otc, there is In May 2011, The Medical and Research Advisory Committee also no consensus on the timing and circumstances of return to 24 (MARAC) of the Sickle Cell Disease Association of America play/return to duty after an episode of ER or ECAST. Public health considerations They concluded, given the lack of scientiﬁc evidence that substanti- Universal newborn screening for SCD in the United States is ates a signiﬁcant correlation between SCT in athletes and training- performed as a public health imperative because early detection of related sudden death, that SCDAA does not support screening of SCD and intervention reduces morbidity and mortality in young athletes for SCT as a means to reduce heat-related illness or death in children. SCDAA also supports the implementation 634 American Society of Hematology Table 3. Alignment of ASH policy with other position documents American Society of Hematology (ASH) Does not support the imposition of testing or disclosure of sickle cell status as a prerequisite for participation in college sports. Endorses the implementation of universal guidelines to reduce exertion-related injuries and deaths because this approach can be effective for all athletes irrespective of their sickle cell status. Believes that the NCAA Division I policy, as currently written and implemented, has the potential to harm the student athlete and the larger community of persons with SCT. Strongly supports increased biomedical and population-based research on SCT as it relates to exertion-related illness, as well as other clinical conditions. Secretary’s Advisory Committee on Heritable Disorders of Newborns and Children (SACHDNC) All persons should have the opportunity to ﬁnd out their risk for various medical disorders, including their carrier status for SCD. Genetic testing should not be a prerequisite for participation in sports unless deemed medically necessary. Evaluation and testing for sickle cell should include counseling regarding the implications of the information for the person and assurance of the privacy. All potential athletes should receive education on safe practices for prevention of exercise and heat-related illnesses as part of the person’s annual medical evaluation for participation in sports. Sickle Cell Disease Association of America (SCDAA) Screening for genetic conditions, outside of state-mandated universal newborn screening, should be voluntary. Universal precautions to reduce dehydration and the chances of heat- or exercise-related illness, as demonstrated in the training of Army recruits, should be implemented for all athletes in training and competition. Screening should be preceded by counseling to explain the beneﬁts and risks of testing and followed by genetic counseling and health education that explain the results and their implications. Screening for SCD and related hemoglobinopathies must not lead to stigmatization or discrimination of those tested based on the testing or its results. Stakeholders should collaborate to collect research-related epidemiologic and clinical data on athletes who are being screened for SCT with the goal of correlating carrier status and sports-related heat injury. Brazilian Consensus Statement Persons with SCT can practice any sports because there are no consistent data that could prevent participation in any sport. There is no need to perform screening for hemoglobinopathies in persons interested in professional or nonprofessional sports. It is not necessary to perform screening tests in order to serve in the Army.